Hepatitis is an inflammation of the liver caused by certain viruses and
other factors, such as alcohol abuse, some medications, and trauma. Its
various forms affect millions of Americans. Although many cases of
hepatitis are not a serious threat to health, the disease can become
chronic (long-lasting) and can sometimes lead to liver failure and
death.

There are four different types of infectious hepatitis viruses, but
only three of them can spread to uninfected people: they are HBV, HCV, and
HDV and can be spread in the following ways (Delta hepatitis, spread by
HDV, is spread only when HBV is present through the same ways listed
below):

Having sexual intercourse with an infected person without
using a condom.

Sharing drug needles among users of injected street
drugs.

Needle-stick accidents among health-care workers.

Mother-to-child transmission of HBV during birth.

Transfusions. Until recently, blood transfusions were the
most frequent cause of hepatitis C. Blood banks in the United States now
screen donated blood for HBV and HCV and discard any blood that appears
to be infected. Therefore, the risk of acquiring hepatitis from these
viruses is very low in the U.S. and in other countries where blood is
similarly tested. Tests to screen blood for HBV will also screen out
HDV.

Personal contact with an infected person. HBV, HCV, and
HDV sometimes spread when household members unknowingly come in contact
with virus-infected blood or body fluids--most probably through cuts and
scrapes or by sharing personal items such as razors and toothbrushes.
While it is possible to become infected by contact with saliva, blood
and semen remain the major sources of infection.

Many people infected with viral hepatitis have no symptoms. For
example, about one-third of people infected with HBV have a completely
"silent" disease. When symptoms are present, they may be mild or severe.
The most common early symptoms are mild fever, headache, muscle aches,
fatigue, loss of appetite, nausea, vomiting, or diarrhea. Later symptoms
may include dark and foamy urine and pale feces; abdominal pain; and
yellowing of the skin and whites of the eyes (jaundice).

About 15 to 20 percent of patients develop short-term arthritis-like
problems as part of a more severe case of hepatitis. Another one-third of
those with hepatitis B develop only mild flu-like symptoms without
jaundice. Very severe (fulminant) hepatitis B is rare, but
life-threatening. Early signs of fulminant hepatitis, such as personality
changes and agitated behavior, require immediate medical attention.

Some people infected with HBV or HCV become chronic carriers of the
virus, although they may have no symptoms. There are an estimated 1.5
million HBV carriers in the U.S. and 300 million carriers worldwide.
Children are at greatest risk. About 90 percent of babies who become
infected at birth with HBV, and up to half of youngsters who are infected
before age 5, become chronic carriers. It is estimated that there are
between 2 and 5 million HCV chronic carriers. At least half of all HCV
carriers will develop chronic liver disease, regardless of whether or not
they have symptoms.

At present, there are no specific treatments for the acute symptoms of
viral hepatitis. Doctors recommend bed rest, a healthy diet, and avoidance
of alcoholic beverages and some medications that are metabolized through
the liver.

How can I reduce my risks of spreading hepatitis?

The most effective means of preventing viral hepatitis is to avoid
contact with the blood, saliva, semen, or vaginal secretions of infected
individuals. People who have acute or chronic viral hepatitis should:

Avoid sharing items that could infect others, such as
razors or toothbrushes.

Protect sex partners from exposure to their semen, vaginal
fluids, or blood. Properly used condoms may be effective in preventing
sexual transmission.

There are several vaccines available to prevent hepatitis B. People at
high risk of infection should consider vaccination:

Male homosexuals and heterosexuals with multiple
partners,

People who receive hemodialysis or blood products,

Household and sexual contacts of HBV carriers, and

Users of intravenous street drugs who share
needles.

Regulations now require health care and laboratory workers who handle
blood and other body fluids to be vaccinated. People who have come into
direct contact with the blood or body fluids of an HBV carrier may receive
one or more injections of hepatitis B immune globulin,sometimes in
combination with hepatitis B vaccine. Immuoglobulin offers temporary
protection, while the vaccine provides a longer-lasting immunity.

In an effort to eliminate chronic carriers, the U.S. Centers for
Disease Control recommends that all newborn babies be vaccinated. Other
groups have recommended that pregnant women be screened for HBsAg as part
of their routine prenatal care. If they are infected, their babies can be
given hepatitis B immune globulin as well as vaccine immediately after
birth.

No vaccines yet exist for HCV or HDV; however, HBV vaccine will prevent
delta hepatitis as well.

This information was abstracted from the National Institute for Allergy
and Infectious Diseases Factsheet "Hepatitis" (1992).

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